Interview with Music Therapist, Elizabeth Huss

by Jake Sibley, About.com

Elizabeth Huss is a professional music therapist. She completed her undergraduate degree in music therapy at the University of Dayton in Ohio and her music therapy internship in Pittsburgh at the Forbes Health System. Her honors thesis, The Effects of Music Therapy Interventions on State Anxiety of Women in Crisis, won the E. Thayer Gaston prize for excellence.

She currently works at Columbus Music Therapy Center, a music therapy contractor.

What Music Therapists Do, How to Become One

What do music therapists do?

Music therapists do many things. I personally work with a variety of clients through a music contracting company. I work with children with severe emotional disturbance and also some with developmental handicaps. I also work in a nursing home. Outside of the contract work, I do a kindermusic program - an early childhood music program.

Tell me what you do with the children.

I work with them in their own homes once a week. Some of these kids have been abused, some have bipolar disorder, some have schizophrenia, quite a few have ADHD, some are autistic, cerebral palsy - all different kinds.

The approach that I take is very improvisational. For example, a couple weeks ago I went to see one of my clients, he's a 12-year old boy with mental retardation and schizophrenia. I actually see him in his school. This particular day he had had a very frustrating day in school. We started by singing the "hello" song we always sing, in which I kind of ask him how he's doing. He said that he was very upset.

We had a piano in the room so we moved to that. I just provided rhythmic support in my part for his melodic improvisation. He doesn't have any piano background, but he was just expressing himself. Then he asked for my drum - I always have a bag of instruments with me - and he played the drum while I played piano. He was very angry, so he was playing hard, fast, and in erratic rhythms. I supported that style, but slowly brought him away from that by playing a little more calmly and softly than he was. Gradually, his drumming calmed, and became a steady, controlled rhythm. At that point, he began to smile for the first time since I'd arrived.

Then, we talked a little bit. He said that he liked the drum, and that he had been very angry, but that he was feeling better.

Is that the goal of music therapy - to bring about a more positive emotional state through the communication of music?

With him, it is. I have other clients who have different goals. For example, I have autistic kids that are very set in their routines. If you interrupt their routines, they go into a tantrum. So with them, I work on gently altering the routine. I do different music each week.

What about the nursing home?

Well, often for older folks that have trouble breathing, we do a lot of singing to help their respiration. We do that a lot especially with pneumonia patients, because it helps keep the infection out of their lungs. If it settles to their lungs, it can kill them.

That's physical therapy as well as emotional.

Absolutely. Also, with my kids, we'll do a lot of singing to work on their speech abilities. So speech development is important. This is true of Alzheimer's patients, too. Many of them can't talk, but they will sing. So I work on helping those people express themselves and communicate by singing. Or, at the very least, they can hum a melody.

Where do music therapists work?

Well, many of us work for contracting companies. The company where I am, we have a few main contracts. One is with the nursing home. Another is with the County Board of Mental Retardation Development, and they have a huge caseload of children. We do in-home services for them. We have a few consulting contracts in schools, through which we teach the teachers techniques to help them integrate music into what they are doing. We also have a contract with a clinical psychologist, and we take referrals from his office.

There are many other institutions that hire music therapists. When I was getting started, I looked at a few nursing homes, I looked at a hospice, I looked at schools, and some psychiatric hospitals and children's hospitals. The hospital positions are a little bit rare, because many of them don't have the budget for a full-time music therapist, but they do exist. And some hospital administrators actually use music therapists to cut costs. For example, they will offer music therapy for pain management and therefore reduce some of the medication costs.

Some people do go into private practice. They contract themselves out privately, through referrals from psychologists, or physical therapists, or speech pathologists.

Where training is required in order to be a music therapist?

We are allowed to practice with a Bachelor's degree in music therapy plus professional certification. There are 70 or 80 schools that provide the Bachelor's program in the U.S., and that list can be obtained from the American Music Therapy Association at MusicTherapy.org. In order to get certified, we have to complete a clinical internship - clinical training period - for a minimum of six months. After that, you take a certification exam to become a Board Certified Music Therapist, abbreviated MT-BC.

Now, there are certain positions which are only available to music therapists that have gone a step further and completed a Masters degree in the field. Masters programs are available, and I believe a Ph.D. program was just begun, as well.

There is also an equivilancy program for professional musicians or psychologists who are interested in a career shift to music therapy, so there is an alternative to the full four-year degree. They also have to complete the clinical internship, of course.

Can you give me an example of a music therapy success story?

There is a music therapist at Colorado State that has been doing neurologic music therapy. His main focus is with stroke patients. He's studied the effects of music on the brain and has developed a program to help certain stroke patients regain their ability to walk through music therapy.

He's discovered that when people listen to music, there is a certain reflex in the brain. After hearing two steady beats, for example, your brain knows when the third beat will come. He uses a metronome or even the patient's preferred music to help them coordinate their legs to the rhythm of the music.

His work has been very successful. He's been on national news shows like Nightline. And insurance companies pay for his work, which is a real accomplishment, because they often don't cover music therapy.

Often the successes in music therapy are more difficult to measure quantitatively, which makes it difficult to prove them on paper, but they are very real. In my internship, I did a rhythm exercise with a group of patients on an Alzheimer's unit. There were people of all stages of the disease in the group. There were people who were very agitated and wouldn't respond to much at all, there were people who were falling asleep, and there were people who were very active. A huge range.

I brought out some drums and we we played along with a song. I saw changes in every single person's level of involvement. The agitated people calmed down, the non-responders started tapping their fingers, the person who would previously only interact with me turned and began to interact with someone else in the group. It's a wonderful thing, but again, it's hard to measure with numbers.

What's the most difficult thing about being a music therapist?

The most difficult thing about the career is justifying it to other people. Most us love what we do and know it does good, but people are often skeptical.

The most diffcult thing about the work itself is burn out. It's a very real problem. I have to struggle to balance work, and home, and my clients, and my time.

What causes this burn out?

It's a combination of the emotional load, the struggle for recognition, many things. A lot of what we do is care work. We build relationships with our clients. It's a very emotional thing, not just with the clients, but also because it's music, and as musicians, that's very important to us emotionally. Most of us are very emotionally involved in our work. We invest alot in the music that we make and the relationships with our clients.

It's particularly difficult when you work with end-stage patients that are near death. You can imagine how difficult it is to build these relationships only to lose your client.

What's the best thing about being a music therapist?

It's incredibly rewarding. It's rewarding to know that you are offering something to the client, and the music is offering something to the client, that may not have been available to them before. I have clients that respond to music in ways that exceed their reponses to everything else.

I have a client who is severly, profoundly retarded. You could go in her room and talk to her and touch her and it will have no effect at all. But once you start playing the music she'll start smiling and shaking her head to the beat of the music. Just having that connection - bringing her out of herself - is amazing.